OLMSTED MEDICAL CENTER: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- OLMSTED MEDICAL CENTER (EIN 41-0855367)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-10-15
- IRS object ID
- 201422909349300022
- Schema version
- 2013v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-10-15T15:45:18-05:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCGLADREY LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 LOCUST ST STE 640 | AddressLine1 |
| City | DES MOINES | City |
| State | IA | State |
| ZIP Code | 503092354 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410855367 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLMSTED MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OLMS | BusinessNameControlTxt |
| Phone | 5072883443 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 NINTH STREET SE | AddressLine1 |
| City | ROCHESTER | City |
| State | MN | State |
| ZIP Code | 55904 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIM WEIR | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 5072883443 | PhoneNum |
| Signature | 2014-09-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KATHY FAIRCHILD | PreparerPersonNm |
| PTIN | P00222608 | PTIN |
| Phone | 5155586600 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KATHRYN LOMBARDO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 NINTH STREET SE | AddressLine1 |
| City | ROCHESTER | City |
| State | MN | State |
| ZIP Code | 55904 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $191,412,524 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.OLMMED.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1949 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | THE DELIVERY OF EXCEPTIONAL PATIENT CARE FOCUSING ON CARING, QUALITY, SAFETY AND SERVICE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 1310 | TotalEmployeeCnt |
| Total Volunteers | 92 | TotalVolunteersCnt |
| Total Gross UBI | $121,302 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$31,789 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,762,761 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,546,060 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $167,158,167 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $181,842,362 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,078,270 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,571,512 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,311,050 | PYOtherRevenueAmt |
| CY Other Revenue | $3,315,664 | CYOtherRevenueAmt |
| PY Total Revenue | $173,310,248 | PYTotalRevenueAmt |
| CY Total Revenue | $189,275,598 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $365,190 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $465,778 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $100,089,456 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $109,446,281 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $395,833 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $57,183,363 | PYOtherExpensesAmt |
| CY Other Expenses | $64,957,815 | CYOtherExpensesAmt |
| PY Total Expenses | $157,638,009 | PYTotalExpensesAmt |
| CY Total Expenses | $174,869,874 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $15,672,239 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $14,405,724 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $182,634,017 | TotalAssetsBOYAmt |
| Total Assets EOY | $218,598,004 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $61,997,354 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $83,532,410 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $120,636,663 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $135,065,594 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE DELIVERY OF EXCEPTIONAL PATIENT CARE FOCUSING ON CARING, QUALITY, SAFETY AND SERVICE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $156,564,589 | ExpenseAmt |
| Grant | $465,778 | GrantAmt |
| Revenue | $182,193,280 | RevenueAmt |
| Desc | PATIENT CARE: PERSONAL APPROACH TO CARE THROUGH MORE THAN 25 SPECIALTIES. ALL OF OUR SPECIALTY SERVICES COMPLIMENT PRIMARY CARE AND OFFER PATIENTS GREATER CONVENIENCE AND PEACE OF MIND. WE CONTINUE TO WORK TO POSITION OMC AS A PREFERRED HEALTHCARE PROVIDER FOR PRIMARY AND SECONDARY CARE AMONG SOUTHEASTERN MINNESOTA RESIDENTS. OMC'S 160 CLINICIANS AND 1,000+ HEALTHCARE PROFESSIONALS SERVE AT 18 LOCATIONS, INCLUDING TWO MULTI-SPECIALTY CLINICS, PHYSICAL/OCCUPATIONAL THERAPY, SPORTS MEDICINE FACILITIES, A LEVEL IV TRAUMA HOSPITAL WITH 24-HOUR EMERGENCY ROOM AND BIRTHCENTER, TWO WALK-IN FASTCARE RETAIL CLINICS, A WALK-IN SKYWAY CLINIC IN DOWNTOWN ROCHESTER, AND 10 COMMUNITY BRANCH CLINICS.RECENT EXPANSION INCLUDES CURRENT CONSTRUCTION OF A 80,000 SQUARE-FOOT WOMEN'S HEALTH PAVILION ADDITION TO OMC'S HOSPITAL IN SOUTHEAST ROCHESTER TO OPEN IN 2014, TWO NEW BRANCH CLINIC FACILITIES, A 15,000 SQUARE-FOOT SPORTS MEDICINE AND ATHLETIC PERFORMANCE FACILITY IN NORTHWEST ROCHESTER, AND A RETAIL PHARMACY AT ROCHESTER NORTHWEST CLINIC.OMC IS ADDING/EXPANDING PROGRAMS IN TELEHEALTH, WOUND CARE, ORTHOPEDICS, BARIATRIC SURGERY, WOMEN'S HEALTH, NON-SURGICAL CARDIOLOGY, NUCLEAR RADIOLOGY, PAIN MANAGEMENT, AND SPORTS MEDICINE/ATHLETIC PERFORMANCE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $94,227 | ExpenseAmt |
| Desc | COMMUNITY OUTREACH AND SUPPORT ACTIVIITES: OMC WELCOMES ITS MANY OPPORTUNITIES TO BE AN ACTIVE, CONTRIBUTING PARTNER TO SOUTHEASTERN MINNESOTA'S HEALTH AND WELLNESS EFFORTS.AS A 501(C)3 NON-PROFIT ORGANIZATION, OMC ACTIVELY SUPPORTS SOUTHEASTERN MINNESOTA'S HEALTH AND WELLNESS EFFORTS THROUGH THE CONTRIBUTION OF STAFF TIME/TALENT, IN-KIND RESOURCES, AND FINANCIAL ASSISTANCE. IN 2013, OUR COMMUNITY CONTRIBUTIONS MADE UP 27.03% OF OUR ANNUAL OPERATING EXPENSES-MORE THAN $45 MILLION IN SUPPORT OF OUR COMMITMENT TO BE AN ACTIVE, CONTRIBUTING PARTNER IN THE COMMUNITIES WE SERVE.ANOTHER WAY OMC ACTIVELY SUPPORTS COMMUNITY HEALTH IS THROUGH ITS PARTNERSHIP WITH MAYO CLINIC, OLMSTED COUNTY PUBLIC HEALTH, AND SEVERAL OTHER COMMUNITY-SERVICE ORGANIZATIONS AS THEY UNDERTAKE THE NEW FEDERALLY MANDATED REQUIREMENT TO PRODUCE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND RELATED ACTION PLAN BY THE END OF TAX YEAR 2013. CLOSE COLLABORATION IS NOTHING NEW FOR US AND OUR LEAD PARTNERS, AND OUR WORK TOGETHER PRODUCED RESULTS THAT EACH OF US CAN ACT ON TO BETTER OUR COMMUNITY'S HEALTH.IN 2013, OMC HOSTED HUNDREDS OF SCHOOL-AGED CHILDREN AND COLLEGE STUDENTS FOR EDUCATION EXPERIENCES DESIGNED TO CULTIVATE THE NEXT GENERATION OF CAREGIVERS. IN ADDITION, OMC'S COMMUNITY INVESTMENT ACTIVITIES SUPPORTED 104 LOCAL AND REGIONAL ORGANIZATIONS DELIVERING FITNESS AND SAFETY, YOUTH, ARTS AND CULTURE, EDUCATION, CIVIC, AND HUMAN SERVICE PROGRAMS THROUGHOUT SOUTHEASTERN MINNESOTA. OUR SUPPORT FOR THOSE COMMUNITY ORGANIZATIONS REMAINS CONSISTENT WITH THE WAY OUR EMPLOYEES CONTINUED TO REACH OUT TO THEIR OWN COMMUNITIES BY VOLUNTEERING.MANY OMC EMPLOYEES SHARE PERSONAL TIME AND TALENT IN VARIOUS COMMUNITY-BASED PROGRAMS, SPENDING APPROXIMATELY 10.3 PERSONAL HOURS AND 5 WORK HOURS PER MONTH ENGAGED IN VOLUNTEER SERVICE. USING THE INDEPENDENT SECTOR'S 2012 ESTIMATED DOLLAR VALUE OF VOLUNTEER TIME ($22.14), THIS MEANS THAT THE AVERAGE OMC VOLUNTEER CONTRIBUTES BETWEEN $112 AND $229 IN TIME AND EFFORT EACH MONTH, OR BETWEEN $1,342 AND $2,745 PER YEAR. THE TOTAL ANNUAL VALUE OF VOLUNTEER TIME SPENT BY THE 302 EMPLOYEES WHO INDICATED ON THIS SURVEY THAT THEY'RE INVOLVED IN NON-PROFIT OR COMMUNITY WORK, THEN, IS $805,454. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,737,564 | ExpenseAmt |
| Revenue | $2,500,274 | RevenueAmt |
| Desc | OMC'S RESEARCH DEPARTMENT, LED BY DR. BARBARA YAWN, MD, HELPS RESEARCHERS FROM AROUND THE WORLD STUDY DISEASES AND CONDITIONS, INCLUDING THE EFFECT OF DISEASES OF PEOPLE'S LIVES AND THE VALUE OF TREATMENT IN PREVENTING, CURING AND IMPROVING TREATMENT OUTCOMES. OMC RESEARCH IS A KEY PARTNER IN STUDIES OF THE HEALTH OF POPULATIONS IN OLMSTED COUNTY AND THROUGHOUT THE UNITED STATES. THE DEPARTMENT HAS INITIATED SEVERAL NATIONAL STUDIES TO IMPROVE THE HEALTH AND MEDICAL CARE OF ALL AMERICANS.BEACON COMMUNITY PROJECT - OMC ASSUMED A LEADERSHIP ROLE IN THE FEDERALLY FUNDED $12.2 MILLION SOUTHEAST MINNESOTA REGION BEACON COMMUNITY PROJECT AND ITS GOAL OF CREATING A NATIONAL MODEL FOR THE SECURE EXCHANGE OF PATIENTS' HEALTH INFORMATION AT ANY POINT OF CLINICAL SERVICE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $159,396,380 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 192 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1310 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEVIN HIGGINS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5072883443 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 102 ELTON HILLS DRIVE NW | AddressLine1 |
| City | ROCHESTER | City |
| State | MN | State |
| ZIP Code | 55901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| RANDY HEMANN MD | ||||||||||
| PHYSICIAN TRUSTEE | 40.00 | Yes (X) | $317,046 | $0 | $47,335 | |||||
| KATHRYN LOMBARDO MD | ||||||||||
| CURRENT PRESIDENT | 40.00 | Yes (X) | $410,498 | $0 | $29,381 | 1.00 | Yes (X) | |||
| ROY A YAWN MD | ||||||||||
| PAST PRESIDENT/PHYS TRUSTEE | 40.00 | Yes (X) | $287,725 | $0 | $30,655 | 1.00 | Yes (X) | |||
| WENDY SHANNON | ||||||||||
| PUBLIC TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| JAY HESLEY | ||||||||||
| CURRENT BRD CHAIR/PUBLIC TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||||
| JUSTIN MCNEILUS | ||||||||||
| PUBLIC TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| JAMES MCPEAK JR | ||||||||||
| PUBLIC TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| JULIE ANDERSON | ||||||||||
| PUBLIC TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| MARY BENIKE KISILEWSKI | ||||||||||
| PUBLIC TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| JAY MYERS MD | ||||||||||
| PHYSICIAN TRUSTEE/SEC/TREA | 40.00 | Yes (X) | $569,738 | $0 | $47,573 | Yes (X) | ||||
| KIMBERLY MCKEON MD | ||||||||||
| PHYSICIAN TRUSTEE | 40.00 | Yes (X) | $302,422 | $0 | $48,483 | |||||
| MELISSA BRINKMAN | ||||||||||
| PUBLIC TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| TOM SLIGHTAM | ||||||||||
| PUBLIC TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| SRDAN BABOVIC MD | ||||||||||
| PHYSICIAN TRUSTEE | 40.00 | Yes (X) | $731,401 | $0 | $32,753 | |||||
| STEVE YAGGY | ||||||||||
| PUBLIC TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| KEN BROWN | ||||||||||
| PUBLIC TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| TIM WEIR | ||||||||||
| CEO | 40.00 | $470,599 | $0 | $46,489 | 1.00 | Yes (X) | ||||
| KEVIN HIGGINS | ||||||||||
| CFO | 40.00 | $335,218 | $0 | $46,670 | 1.00 | Yes (X) | ||||
| DAVID WESTGARD | ||||||||||
| CHIEF MEDICAL OFFICER | 40.00 | $433,173 | $0 | $39,599 | 1.00 | Yes (X) | ||||
| VIDHAN CHANDRA MD | ||||||||||
| PHYSICIAN | 40.00 | $808,413 | $0 | $31,410 | Yes (X) | |||||
| JOEL SOLANO MD | ||||||||||
| PHYSICIAN | 40.00 | $582,425 | $0 | $30,332 | Yes (X) | |||||
| ROBERT KURLAND MD | ||||||||||
| PHYSICIAN | 40.00 | $577,787 | $0 | $42,793 | Yes (X) | |||||
| MARCO SANTAMARIA MD | ||||||||||
| PHYSICIAN | 40.00 | $553,179 | $0 | $50,944 | Yes (X) | |||||
| GRAHAM RITTS MD | ||||||||||
| PHYSICIAN | 40.00 | $541,274 | $0 | $36,422 | Yes (X) | |||||
| LINDA WILLIAMS MD | ||||||||||
| FORMER PHYSICIAN TRUSTEE | 40.00 | $203,012 | $0 | $31,912 | Yes (X) | |||||
| CHARLES BRANCH MD | ||||||||||
| FORMER PHYSICIAN TRUSTEE | 40.00 | $539,688 | $0 | $49,736 | Yes (X) | |||||
| JAMES HOFFMAN DO | ||||||||||
| FORMER PHYSICIAN TRUSTEE | 40.00 | $391,248 | $0 | $46,259 | Yes (X) | |||||
| THOMAS ERBACH MD | ||||||||||
| FORMER PHYSICIAN TRUSTEE | 40.00 | $320,791 | $0 | $30,347 | Yes (X) | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $8,375,637 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $719,093 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 163 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MAYO COLLABORATIVE SERVICES | |||||
| 200 1ST STREET SW | ROCHESTER | MN | 55905 | MEDICAL SERVICES | $1,192,825 |
| THE AFFILIATED GROUP INC | |||||
| PO BOX 7739 | ROCHESTER | MN | 55903 | BILLING & COLLECTION SERVICES | $714,153 |
| NUANCE COMMUNICATIONS INC | |||||
| PO BOX 2561 | CAROL STREAM | IL | 601322561 | TRANSCRIPTION SERVICES | $547,564 |
| CERNER CORPORATION | |||||
| 2800 ROCKCREEK PARKWAY | KANSAS CITY | MO | 64141 | COMPUTER SUPPORT | $510,638 |
| UNIVERSAL HOSPITAL SERVICE INC | |||||
| SDS 12-0940 PO BOX 86 | MINNEAPOLIS | MN | 554860940 | EQUIPMENT MAINTENANCE | $472,265 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 70 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $45,786 | RelatedOrganizationsAmt |
| Government Grants | $2,361,799 | GovernmentGrantsAmt |
| All Other Contributions | $138,475 | AllOtherContributionsAmt |
| Total Contributions | $2,546,060 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICES | 621110 | $181,336,457 | $181,336,457 | |
| PHARMACY | 446110 | $505,905 | $384,603 | $121,302 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $181,842,362 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,233,091 | TotalRevenueColumnAmt |
| Exclusion | $1,233,091 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $98,224 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $98,224 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $98,224 | TotalRevenueColumnAmt |
| Exclusion | $98,224 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,475,347 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,073,893 | SecuritiesAmt |
| Other | $63,033 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $401,454 | SecuritiesAmt |
| Other | -$63,033 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $338,421 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$63,033 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $401,454 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| ELECTRONIC HEALTH RECORDS INCENTI | 900099 | $2,294,242 | $2,294,242 | |
| CAFETERIA REVENUE | 722210 | $181,913 | $181,913 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $741,285 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $741,285 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,217,440 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $189,275,598 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $184,693,554 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $121,302 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,914,682 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $465,778 | TotalAmt |
| Program Services | $465,778 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,826,439 | TotalAmt |
| Program Services | $2,275,977 | ProgramServicesAmt |
| Management And General | $1,550,462 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,830,245 | TotalAmt |
| Program Services | $1,830,245 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,245,647 | TotalAmt |
| Program Services | $74,033,425 | ProgramServicesAmt |
| Management And General | $5,941,171 | ManagementAndGeneralAmt |
| Fundraising | $271,051 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,076,664 | TotalAmt |
| Program Services | $5,623,109 | ProgramServicesAmt |
| Management And General | $432,239 | ManagementAndGeneralAmt |
| Fundraising | $21,316 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,990,929 | TotalAmt |
| Program Services | $11,043,151 | ProgramServicesAmt |
| Management And General | $863,454 | ManagementAndGeneralAmt |
| Fundraising | $84,324 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,476,357 | TotalAmt |
| Program Services | $5,041,944 | ProgramServicesAmt |
| Management And General | $415,271 | ManagementAndGeneralAmt |
| Fundraising | $19,142 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $284,913 | TotalAmt |
| Program Services | $213,146 | ProgramServicesAmt |
| Management And General | $71,767 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,431 | TotalAmt |
| Program Services | $98,124 | ProgramServicesAmt |
| Management And General | $90,307 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,066 | TotalAmt |
| Management And General | $220,066 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,188 | TotalAmt |
| Program Services | $79 | ProgramServicesAmt |
| Management And General | $62,109 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,537,491 | TotalAmt |
| Program Services | $8,529,265 | ProgramServicesAmt |
| Management And General | $1,008,226 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $401,264 | TotalAmt |
| Program Services | $5,670 | ProgramServicesAmt |
| Management And General | $395,594 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,157,304 | TotalAmt |
| Program Services | $2,626,080 | ProgramServicesAmt |
| Management And General | $531,224 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $874,307 | TotalAmt |
| Program Services | $341,209 | ProgramServicesAmt |
| Management And General | $533,098 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,965,651 | TotalAmt |
| Program Services | $4,279,821 | ProgramServicesAmt |
| Management And General | $685,830 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,162 | TotalAmt |
| Program Services | $58,660 | ProgramServicesAmt |
| Management And General | $10,502 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $832,711 | TotalAmt |
| Program Services | $660,297 | ProgramServicesAmt |
| Management And General | $172,414 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,764,939 | TotalAmt |
| Program Services | $1,712,623 | ProgramServicesAmt |
| Management And General | $52,316 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,166,135 | TotalAmt |
| Program Services | $7,166,135 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $689,767 | TotalAmt |
| Program Services | $689,767 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $16,538,529 | $16,532,183 | $6,346 |
| PROVISION FOR BAD DEBTS | $7,913,386 | $7,913,386 | |
| EQUIPMENT & SOFTWARE MA | $4,098,494 | $2,938,940 | $1,159,554 |
| MISCELLANEOUS | $3,303,456 | $2,427,745 | $875,711 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,889,621 | TotalAmt |
| Program Services | $2,889,621 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,869,874 | TotalAmt |
| Program Services | $159,396,380 | ProgramServicesAmt |
| Management And General | $15,077,661 | ManagementAndGeneralAmt |
| Fundraising | $395,833 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,189,740 | BOYAmt |
| EOY | $85,343,961 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,888,778 | BOYAmt |
| EOY | $29,558,546 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,251,128 | BOYAmt |
| EOY | $1,612,877 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,777,873 | BOYAmt |
| EOY | $5,167,197 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $123,338,695 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $47,410,089 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,835,269 | BOYAmt |
| EOY | $75,928,606 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,890,020 | BOYAmt |
| EOY | $20,005,981 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $801,209 | BOYAmt |
| EOY | $980,836 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $182,634,017 | BOYAmt |
| EOY | $218,598,004 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,750,818 | BOYAmt |
| EOY | $3,873,160 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,256 | BOYAmt |
| EOY | $677,797 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,152,905 | BOYAmt |
| EOY | $35,605,000 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $160,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,925,508 | BOYAmt |
| EOY | $18,987,656 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,775,867 | BOYAmt |
| EOY | $24,388,797 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,997,354 | BOYAmt |
| EOY | $83,532,410 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,636,663 | BOYAmt |
| EOY | $135,065,594 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,636,663 | BOYAmt |
| EOY | $135,065,594 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $182,634,017 | BOYAmt |
| EOY | $218,598,004 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $14,405,724 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $23,207 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,285,183 | OtherCostOrOtherBasisAmt |
| Book Value | $5,285,183 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $72,242,056 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,566,528 | DepreciationAmt |
| Book Value | $51,675,528 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $45,636,675 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,703,854 | DepreciationAmt |
| Book Value | $18,932,821 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $174,781 | OtherCostOrOtherBasisAmt |
| Depreciation | $139,707 | DepreciationAmt |
| Book Value | $35,074 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $75,928,606 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| PAYROLL LIABILITY | $14,694,070 |
| OTHER ACCRUED LIABILITY | $6,671,783 |
| ACCRUED INTEREST | $930,022 |
| ACCRUED REAL ESTATE TAXES | $873,172 |
| THIRD PARTY PAYOR SETTLEMENTS | $1,219,750 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $24,388,797 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | OLMSTED MEDICAL CENTER AND THE OMC REGIONAL FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAXES AS TAX-EXEMPT ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT FOR INCOME ON CERTAIN UNRELATED BUSINESS INCOME. THERE IS NO MATERIAL UNRELATED BUSINESS INCOME FOR THE YEARS ENDED DECEMBER 31, 2013 AND 2012. THE MEDICAL CENTER AND FOUNDATION ARE ALSO EXEMPT FROM STATE INCOME TAXES UNDER APPLICABLE MINNESOTA STATUTES. THE MEDICAL CENTER AND FOUNDATION FILE FEDERAL AND STATE INCOME TAX RETURNS. GENERALLY, THE MEDICAL CENTER AND THE FOUNDATION ARE NO LONGER SUBJECT TO STATE AND FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEAR ENDED DECEMBER 31, 2009, AND PRIOR. OMC RETAIL SERVICES, LLC IS A DISREGARDED LLC UNDER IRS REGULATIONS, AND IT ACHIEVES TAX-EXEMPT TREATMENT BASED ON THE EXEMPT STATUS OF ITS PARENT, OLMSTED MEDICAL CENTER. AT DECEMBER 31, 2013, THERE WERE NO UNCERTAIN TAX POSITIONS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 260.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,356,286 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,356,286 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00810 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,856,590 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,094,569 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,762,021 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07040 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,650,554 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $568,504 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,082,050 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01850 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,863,430 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,663,073 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,200,357 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09700 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $94,228 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $94,228 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $862,727 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $862,727 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00520 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,100,433 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,500,274 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $600,159 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $349,149 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $349,149 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,406,537 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,500,274 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,906,263 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01150 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,269,967 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,163,347 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,106,620 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10850 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $7,913,386 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $12,329,655 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $19,485,312 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$7,155,657 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLMSTED MEDICAL CENTER-HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1650 4TH STREET SE | AddressLine1 |
| City | ROCHESTER | City |
| State | MN | State |
| ZIP Code | 55904 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Research Facility | Yes (X) | ResearchFacilityInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Emergency Room Other | Yes (X) | EmergencyRoomOtherInd |
| Other | URGENT CARE | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLMSTED MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | OLMMED.ORG | OwnWebsiteURLTxt |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 260.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Other Factors | Yes (X) | OtherFactorsInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| OLMSTED MEDICAL CENTER | PART V, SECTION B, LINE 3: OLMSTED MEDICAL CENTER LAUNCHED A COLLABORATIVE EFFORT WITH OLMSTED COUNTY, MAYO CLINIC, MANY OF THE COMMUNITY BENEFIT NON-PROFIT ORGANIZATIONS AND THE PUBLIC TO IDENTIFY THE COMMUNITY NEEDS. |
| OLMSTED MEDICAL CENTER | PART V, SECTION B, LINE 4: OLMSTED MEDICAL CENTER COLLABORATED WITH MAYO CLINIC AND OLMSTED COUNTY TO PRODUCE THE COMMUNITY NEEDS ASSESSMENT. |
| OLMSTED MEDICAL CENTER | PART V, SECTION B, LINE 7: OLMSTED MEDICAL CENTER REVIEWED INFANT MORTALITY, MORBIDITY, HEALTH BEHAVIORS, CLINICAL CARE, SOCIAL AND ECONOMIC FACTORS, PHYSICAL ENVIRONMENT, ADOLESCENT CHEMICAL HEALTH, DENTAL ISSUES, DIABETES, MATERNAL MORTALITY, MENTAL ILLNESS-ADULTS, MENTAL ILLNESS-CHILDREN AND OBESITY. KNOWING WE HAD LIMITED RESOURCES (TIME, MONEY, KNOWLEDGE) THE COMMITTEE OPTED TO ADDRESS WHAT IT CONSIDERED THE THREE MOST IMPORTANT ISSUES. |
| OLMSTED MEDICAL CENTER | PART V, SECTION B, LINE 12I: OMC VOLUNTARILY ENTERED INTO AN AGREEMENT WITH THE MINNESOTA ATTORNEY GENERAL RELATING TO CHARITY CARE. THE TERMS OF THE AGREEMENT INCLUDE AN AUTOMATIC DISCOUNT FOR UNINSURED PATIENTS, A PAYMENT CAP FOR THOSE UNINSURED PATIENTS THAT MEET THE HOSPITAL'S CHARITY CARE CRITERIA, AND A COMMITMENT TO MAKE INFORMATION AVAILABLE TO PATIENTS REGARDING THE CHARITY CARE PROGRAM. ADDITIONALY, OMC HAS SIGNED AN AGREEMENT WITH THE MINNESOTA STATE ATTORNEY GENERAL TO FOLLOW THE ATTORNEY GENERAL'S BILLING AND COLLECTION PRACTICES PER THE ATTORNEY GENERAL'S LETTER. |
| OLMSTED MEDICAL CENTER | PART V, SECTION B, LINE 20D: THERE WAS NO CAP ON THE AMOUNT OF PATIENT FAP. |
| PART V, SECTION B, LINE 14: | OMC VOLUNTARILY ENTERED INTO AN AGREEMENT WITH THE MINNESOTA ATTORNEY GENERAL RELATING TO CHARITY CARE. THE TERMS OF THE AGREEMENT INCLUDE AN AUTOMATIC DISCOUNT FOR UNINSURED PATIENTS, A PAYMENT CAP FOR THOSE UNINSURED PATIENTS THAT MEET THE HOSPITAL'S CHARITY CARE CRITERIA, AND A COMMITMENT TO MAKE INFORMATION AVAILABLE TO PATIENTS REGARDING THE CHARITY CARE PROGRAM. ADDITIONALY, OMC HAS SIGNED AN AGREEMENT WITH THE MINNESOTA STATE ATTORNEY GENERAL TO FOLLOW THE ATTORNEY GENERAL'S BILLING AND COLLECTION PRACTICES PER THE ATTORNEY GENERAL'S LETTER. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 18 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (18 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| OLMSTED MEDICAL CENTER - MAIN CLINIC | ||||
| 210 NINTH STREET SE | ROCHESTER | MN | 55904 | MAIN CLINIC - OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - BYRON CLINIC | ||||
| 846 HIGH POINT DR NE | BYRON | MN | 55920 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - CHATFIELD CLINIC | ||||
| 207 TWIFORD STREET SW | CHATFIELD | MN | 55923 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - CANNON FALLS CLINIC | ||||
| 1705 HIGHWAY 20 | CANNON FALLS | MN | 55009 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - PINE ISLAND CLINIC | ||||
| 111 COUNTY ROAD 11 NW | PINE ISLAND | MN | 55963 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - PLAINVIEW CLINIC | ||||
| 20 2ND AVENUE NE | PLAINVIEW | MN | 55964 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - PRESTON CLINIC | ||||
| 405 KANSAS STREET NW | PRESTON | MN | 55965 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - ST CHARLES CLINIC | ||||
| 403 W FOURTH STREET | ST CHARLES | MN | 55972 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - SPRING VALLEY CLINIC | ||||
| 302 WEST TRACY ROAD | SPRING VALLEY | MN | 55975 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - STEWARTVILLE CLINIC | ||||
| 208 CENTERTOWN PLAZA | STEWARTVILLE | MN | 55976 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - WANAMINGO CLINIC | ||||
| 217 MAIN STREET STE B | WANAMINGO | MN | 55983 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - FASTCARE NORTH CLINIC | ||||
| 3708 HIGHWAY 63N | ROCHESTER | MN | 55906 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - FASTCARE SOUTH CLINIC | ||||
| 2820 S BROADWAY | ROCHESTER | MN | 55904 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - NW CLINIC | ||||
| 5067 55TH STREET NW | ROCHESTER | MN | 55901 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - SKYWAY CLINIC | ||||
| 318 1ST AVENUE SW SUITE 203 | ROCHESTER | MN | 55902 | OUTPATIENT PHYSICIAN CLINIC |
| OLMSTED MEDICAL - PHYSICAL THERAPY | ||||
| 102 ELTON HILLS DRIVE | ROCHESTER | MN | 55901 | PHYSICAL THERAPY CENTER |
| OLMSTED MEDICAL - RESEARCH DEPT | ||||
| 829 3RD AVE SE KINGS ROW | ROCHESTER | MN | 55904 | RESEARCH FACILITY |
| OLMSTED MEDICAL CENTER - SPORTS MED | ||||
| 5155 55TH STREET NW | ROCHESTER | MN | 55901 | PHYSICAL THERAPY/ATHLETIC PERFORMANCE |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | FEDERAL POVERTY GUIDELINES ARE USED FOR DETERMINING FINANCIAL ASSISTANCE. |
| PART I, LINE 7: | LINE 7A-7C: AMOUNTS SHOWN ARE BASED UPON A COST-TO-CHARGE RATIO FROM IRS WORKSHEET 2.LINE 7E-7I: AMOUNTS SHOWN ARE BASED UPON THE ORGANIZATIONS COST ACCOUNTING SYSTEM. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 7,913,386. |
| PART I, LINE 6A: | THE OLMSTED MEDICAL CENTER ANNUAL REPORT IS MADE WIDELY AVAILABLE AND IS AVAILABLE ON THE WEBSITE. |
| PART III, LINE 4: | THE FOOTNOTE FROM THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE IS AS FOLLOWS: PATIENT ACCOUNTS RECEIVABLE DUE DIRECTLY FROM THE PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED, LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS AND BY HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF PATIENT ACCOUNTS RECEIVABLE PREVIOUSLY WRITTEN OFF ARE RECORDED WHEN RECEIVED. |
| PART III, LINE 8: | THE ORGANIZATION DERIVED ITS COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT BY USING COST REPORT WORKSHEETS. MEDICARE COSTS ARE DETERMINED THROUGH THE MEDICARE COST FINDING PROCESS WHICH ALLOCATES GENERAL SERVICE CENTER COSTS TO REVENUE DEPARTMENTS. THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA.THE REASONS MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT ARE: ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND THE AMOUNT SPENT TO COVER MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS.AS REPORTED ON THE AUDITED FINANCIAL STATEMENTS, THE COMMUNITY BENEFIT OF COSTS IN EXCESS OF MEDICARE PAYMENTS WAS $17,599,632. |
| PART III, LINE 9B: | PATIENT FINANCIAL HARDSHIP POLICY: TO SUPPORT THE ORGANIZATION'S MISSION AND PHILOSOPHY IN THAT THE PATIENT COMES FIRST AND PROVIDE A GUIDELINE IN IDENTIFYING PATIENT'S WHO HAVE AN EXCEPTIONAL PERSONAL FINANCIAL HARDSHIP AND REQUIRED NEEDED AND NECESSARY MEDICAL CARE AND THERE IS REMOTE OR NEGLIBLE CHANCE THAT THE INDIVIDUAL WILL BE ABLE TO REPAY. PROCEDURE: FACTORS THAT MAY CONTRIBUTE TO EXCEPTIONAL FINANCIAL HARDSHIP INCLUDE:1) UNEMPLOYMENT OR UNDEREMPLOYMENT THROUGH NO FAULT OF THE PATIENT AND/OR FAMILY; 2) THREATENED LOSS OF SHELTER THROUGH FORECLOSURE, ETC; 3) LOSS OF INCOME FROM FEDERAL, STATE OR OTHER GOVERNMENT BENEFITS INCLUDING, BUT NOT LIMITED TO SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, PUBLIC ASSISTANCE, ETC; 4) LOSS OF INCOME DUE TO DEATH OR DISABILITY; 5) EXCEPTIONAL EXPENSES INCURRED BECAUSE OF UNINSURED PROPERTY DAMAGE OR COSTLY REPAIRS TO PRINCIPAL RESIDENCE; 6) EXCEPTIONAL EXPENSES DUE TO TEMPORARY OR CHRONIC ILLNESS; 7) EXCEPTIONAL EXPENSES DUE TO INCREASE IN LIVING EXPENSES BECAUSE OF A DIVORCE, ABANDONMENT OR SEPARATION FROM SPOUSE OR INCOME EARNER; 8) LOSS OF INCOME DUE TO DECLARATION OF INCOMPETENCE OR IN PROCESS OF BEING DECLARED INCOMPETENT; 9) PATIENT OR FAMILY MEMBER IS CONFINED TO A CONVALESCENT HOME OR OTHER RESIDENCE OTHER THAN THEIR PRINCIPAL RESIDENCE; 10) NATURAL DISASTERS SUCH AS FLOODS, FIRES, HURRICANES AND EARTHQUAKES; 11) EVICTION, HOMELESSNESS, LOSS OF OWNED RESIDENCE, ARSON, THEFT, ETC; 12) DISCONTINUANCE OF UTILITIES OR HEAT, OR UNSAFE OR UNHEALTHY LIVING CONDITIONS; 13) ANY OTHER CONDITION CONSIDERED LIFE THREATENING DUE TO EXCEPTIONAL FINANCIAL HARDSHIP.APPLICATION PROCESS: THE FINANCIAL HARDSHIP APPLICATION, UTILIZING OMC'S FINANCIAL ASSISTANCE APPLICATION, CONTAINS THE NECESSARY INFORMATION TO DETERMINE ELIGIBILITY FOR THE OMC FINANCIAL HARDSHIP PROGRAM. NO SEPARATE APPLICATION IS NECESSARY. SUPPORTING DOCUMENTATION REQUIRED TO MAKE AN ELIGIBILITY DETERMINATION ARE: 1) MOST RECENT TAX RETURNS, 2) CURRENT FAMILY PAYROLL STUB SHOWING YEAR-TO-DATE INCOME; 3) CURRENT TRANSUNION CREDIT REPORT AND OTHER FINANCIAL HARDSHIP DOCUMENTATION TO SUPPORT HARDSHIP; 4) EXPLANATION OF HARDSHIP SITUATION/NECESSITY AND RARE COMPLICATIONS.ELIGIBILITY DETERMINATION: BASED UPON PATIENT'S/FAMILY'S INCOME AND ASSETS AND COMPLETED FINANCIAL ASSISTANCE APPLICATION. BASED UPON TAKING INTO CONSIDERATION ALL PERSONAL FACTORS IN DETERMINING EXCEPTIONAL FINANCIAL HARDSHIP. THE BUSINESS SERVICES DEPARTMENT EVALUATES THE APPLICATIONS MEETING THE CRITERIA AND PRESENTS TO ADMINISTRATION FOR APPROVAL. OMC RESERVES THE RIGHT TO MAKE ADJUSTMENT DETERMINATIONS ON A CASE-BY-CASE BASIS. |
| PART III, SECTION A, LINE 1: | THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HFMA STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP. |
| PART III, LINE 2: | PATIENT ACCOUNTS RECEIVABLE DUE DIRECTLY FROM THE PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED, LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS AND BY HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF PATIENT ACCOUNTS RECEIVABLE PREVIOUSLY WRITTEN OFF ARE RECORDED WHEN RECEIVED. |
| PART III, LINE 3: | WHEN OMC IDENTIFIES A PATIENT AS ELIGIBLE FOR FINANCIAL ASSISTANCE, OMC PERFORMS A LOOK-BACK TO SEE IF THE PATIENT HAS PREVIOUS BAD DEBT. IF SO, OMC RECLASSIFIES THAT AMOUNT OUT OF BAD DEBT AND INTO A FINANCIAL ASSISTANCE CODE. |
| PART VI, LINE 2: | OMC ACTIVELY WORKS WITH LOCAL GOVERNMENT IN ASSESSING AND ADDRESSING COMMUNITY NEEDS THROUGH MEETINGS, WORKSHOPS, AND COMMUNITY INPUT. IN ADDITION, OMC IS ACTIVELY INVOLVED WITH LOCAL GOVERNMENTS IN EMERGENCY PREPAREDNESS AND DISEASE MANAGEMENT. |
| PART VI, LINE 3: | OMC INFORMS PATIENTS OF THE FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AND ASSISTS PATIENTS WHO INDICATE AN INABILITY TO PAY. OMC INFORMS PATIENTS OF THE FINANCIAL ASSISTANCE PROGRAMS BY PROVIDING THE FINANCIAL ASSISTANCE POLICY ON BROCHURES IN THE NEW PATIENT PACKET AND AT THE FRONT DESK FOR ALL PATIENTS. THE POLICY IS ALSO PROVIDED ON THE BACK OF THE HOSPITAL BILL STATEMENTS, ON THE HOSPITAL WEBSITE AND ON THE HOSPITAL'S ONLINE BILL-PAY SYSTEM. OMC PATIENT FINANCIAL COUNSELORS PROVIDE INFORMATION TO PATIENTS REGARDING AVAILABLE HEALTHCARE FINANCIAL COVERAGE OPTIONS, SUCH AS: 1) MEDICAL ASSISTANCE, 2) MINNESOTA CARE, 3) OTHER FINANCIAL SERVICES AVAILABLE FOR LOW INCOME FAMILIES IN THE COMMUNITY, 4) OMC'S FINANCIAL ASSISTANCE PROGRAM.THE PATIENT FINANCIAL COUNSELORS ASSIST OMC PATIENTS IN THE APPLICATION PROCESS. ALL APPLICATIONS ARE PROCESSED IN A TIMELY MANNER. PATIENT APPLICATIONS ARE CONSIDERED FOR CURRENT PATIENT RESPONSIBLE BALANCES, AS WELL AS NEAR FUTURE SCHEDULED MEDICAL SERVICES. PATIENTS MAY QUALIFY FOR FULL OR PARTIAL FINANCIAL ASSISTANCE. PATIENT FINANCIAL COUNSELORS NOTE PATIENT'S ACCOUNT VIA ON-LINE NOTES REGARDING APPLICATIONS SENT, APPLICATIONS IN PROCESS, AND WHETHER APPLICATIONS HAVE BEEN APPROVED, DENIED, OR ADDITIONAL INFORMATION IS REQUIRED. THE PATIENT FINANCIAL COUNSELORS INFORM THE PATIENT VIA A LETTER REGARDING THE DETERMINATION (APPROVED, DENIED, OR PARTIAL COVERAGE APPROVED) OF THE RECEIVED AND COMPLETED APPLICATION. PRIOR TO TURNING ACCOUNTS OVER THE THIRD PARTY COLLECTION, THE ACCOUNT WILL BE REVIEWED FOR POSSIBLE FINANCIAL ASSISTANCE PROGRAM QUALIFICATION THROUGH THE E-BUREAU PROCESS. |
| PART VI, LINE 4: | OMC IS A REGIONAL HEALTH CARE FACILITY SERVING PATIENTS WITHIN A SIXTY MILE RADIUS OF ROCHESTER, MN. |
| PART VI, LINE 5: | THE FILING ORGANIZATION MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY, 7 DAYS A WEEK WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY. MEDICAL STAFF PRIVILEGES ARE OPEN TO ALL QUALIFIED PHYSICIANS IN THE AREA.THE ORGANIZATION UTILIZES ITS SURPLUS FUNDS TO INCREASE THE SERVICES OFFERED TO ITS PATIENTS. THE ORGANIZATION HAS EXPANDED THE OPERATIONS AT FASTCARE FACILITIES AND ADDED CARDIOLOGY AND ENDOCRINOLOGY SERVICES FOR ITS PATIENTS. |
| PART VI, LINE 6: | N/A |
| PART VI, LINE 7: | THE ORGANIZATION DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF MINNESOTA. HOWEVER, COMMUNITY BENEFIT INFORMATION IS PROVIDED TO THE MINNESOTA HOSPITAL ASSOCIATION WHICH IS THEN USED IN A STATEWIDE SUMMARY REPORT OF COMMUNITY BENEFITS PROVIDED BY MINNESOTA HOSPITALS. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| OLMSTED MEDICAL CENTER REGIONAL FOUNDATION | |||||||
| 210 9TH STREET SE | ROCHESTER | MN | 55904 | 260022777 | 501(C)(3) | $465,778 | PROVIDE FUNDING TO OMC REGIONAL FOUNDATION FOR HEALTHCARE EDUCATION AND COMMUNITY PURPOSES. |
| (no name) | |||||||
| PROVIDE FUNDING TO UNDERWRITE CHILDREN'S PROGRAM | |||||||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MOST OF GRANT EXPENDITURES ARE PROVIDED TO OLMSTED MEDICAL CENTER REGIONAL FOUNDATION, A RELATED ORGANIZATION. OMC PROVIDES FUNDS TO THE FOUNDATION FOR HEALTHCARE EDUCATION AND COMMUNITY PURPOSES AS NEEDED. THERE ARE NUMEROUS WAYS TO MONITOR THE USE OF THE GRANT FUNDS. MANY OF THE EVENTS ARE OPEN TO THE PUBLIC AND EASILY VERIFIABLE. STAFF OFTEN ASSIST AS VOLUNTEERS. THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE ITS MISSION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS COMMUNITY NEEDS IN THE HEALTH CARE AREA. NO ADDITIONAL MONITORING IS PERFORMED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RANDY HEMANN MD | ||||||||||||||
| PHYSICIAN TRUSTEE | $303,360 | $0 | $11,134 | $0 | $2,552 | $0 | $25,500 | $0 | $21,835 | $0 | $364,381 | $0 | $0 | $0 |
| KATHRYN LOMBARDO MD | ||||||||||||||
| CURRENT PRESIDENT | $394,173 | $0 | $14,199 | $0 | $2,126 | $0 | $25,500 | $0 | $3,881 | $0 | $439,879 | $0 | $0 | $0 |
| ROY A YAWN MD | ||||||||||||||
| PAST PRESIDENT/PHYS TRUSTEE | $205,814 | $0 | $76,518 | $0 | $5,393 | $0 | $25,500 | $0 | $5,155 | $0 | $318,380 | $0 | $0 | $0 |
| JAY MYERS MD | ||||||||||||||
| PHYSICIAN TRUSTEE/SEC/TREA | $560,722 | $0 | $7,232 | $0 | $1,784 | $0 | $25,500 | $0 | $22,073 | $0 | $617,311 | $0 | $0 | $0 |
| KIMBERLY MCKEON MD | ||||||||||||||
| PHYSICIAN TRUSTEE | $300,617 | $0 | $0 | $0 | $1,805 | $0 | $25,500 | $0 | $22,983 | $0 | $350,905 | $0 | $0 | $0 |
| SRDAN BABOVIC MD | ||||||||||||||
| PHYSICIAN TRUSTEE | $728,084 | $0 | $0 | $0 | $3,317 | $0 | $25,500 | $0 | $7,253 | $0 | $764,154 | $0 | $0 | $0 |
| TIM WEIR | ||||||||||||||
| CEO | $358,592 | $0 | $111,125 | $0 | $882 | $0 | $25,500 | $0 | $20,989 | $0 | $517,088 | $0 | $0 | $0 |
| KEVIN HIGGINS | ||||||||||||||
| CFO | $275,606 | $0 | $58,979 | $0 | $633 | $0 | $25,500 | $0 | $21,170 | $0 | $381,888 | $0 | $0 | $0 |
| DAVID WESTGARD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $328,481 | $0 | $97,905 | $0 | $6,787 | $0 | $25,500 | $0 | $14,099 | $0 | $472,772 | $0 | $0 | $0 |
| VIDHAN CHANDRA MD | ||||||||||||||
| PHYSICIAN | $805,057 | $0 | $2,206 | $0 | $1,150 | $0 | $25,500 | $0 | $5,910 | $0 | $839,823 | $0 | $0 | $0 |
| JOEL SOLANO MD | ||||||||||||||
| PHYSICIAN | $581,793 | $0 | $0 | $0 | $632 | $0 | $25,500 | $0 | $4,832 | $0 | $612,757 | $0 | $0 | $0 |
| ROBERT KURLAND MD | ||||||||||||||
| PHYSICIAN | $567,410 | $0 | $4,760 | $0 | $5,617 | $0 | $25,500 | $0 | $17,293 | $0 | $620,580 | $0 | $0 | $0 |
| MARCO SANTAMARIA MD | ||||||||||||||
| PHYSICIAN | $550,096 | $0 | $0 | $0 | $3,083 | $0 | $25,500 | $0 | $25,444 | $0 | $604,123 | $0 | $0 | $0 |
| GRAHAM RITTS MD | ||||||||||||||
| PHYSICIAN | $538,270 | $0 | $0 | $0 | $3,004 | $0 | $12,750 | $0 | $23,672 | $0 | $577,696 | $0 | $0 | $0 |
| LINDA WILLIAMS MD | ||||||||||||||
| FORMER PHYSICIAN TRUSTEE | $188,424 | $0 | $11,858 | $0 | $2,730 | $0 | $20,050 | $0 | $11,862 | $0 | $234,924 | $0 | $0 | $0 |
| CHARLES BRANCH MD | ||||||||||||||
| FORMER PHYSICIAN TRUSTEE | $534,090 | $0 | $0 | $0 | $5,598 | $0 | $25,500 | $0 | $24,236 | $0 | $589,424 | $0 | $0 | $0 |
| JAMES HOFFMAN DO | ||||||||||||||
| FORMER PHYSICIAN TRUSTEE | $382,545 | $0 | $6,599 | $0 | $2,104 | $0 | $25,500 | $0 | $20,759 | $0 | $437,507 | $0 | $0 | $0 |
| THOMAS ERBACH MD | ||||||||||||||
| FORMER PHYSICIAN TRUSTEE | $313,325 | $0 | $0 | $0 | $7,466 | $0 | $25,500 | $0 | $4,847 | $0 | $351,138 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J PART II | FormAndLineReferenceDesc |
| Explanation | COMPENSATION PAID TO PHYSICIAN TRUSTEES IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS EMPLOYED PHYSICIANS OF THE ORGANIZATION. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| CITY OF ROCHESTER MINNESOTA | ||||||||
| A | 416005494 | 771902FY4 | 2010-07-07 | $20,360,000 | CLINIC CONSTRUCTION | 0 | 0 | 0 |
| CITY OF ROCHESTER MINNESOTA | ||||||||
| B | 416005494 | 771902GU1 | 2013-04-01 | $17,260,000 | WOMEN'S HEALTH PAVILLION CONSTRUCTION | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $20,202,546 | $1,736,608 | $1,341,608 | $407,200 | $17,968,405 | $275,180 | 2011 | 0 | 0 | Yes (1) | Yes (1) |
| B | $19,290,018 | $490,226 | $286,285 | $16,403,355 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| JULIE WINKELS | |||
| FAMILY MEMBER OF THOMAS WINKELS, FORMER TRUSTEE | $41,881 | EMPLOYEE OF ORGANIZATION | 0 |
| DR LOUIS WAGNER | |||
| FAMILY MEMBER OF DR. LINDA WILLIAMS, FORMER TRUSTEE | $335,471 | EMPLOYEE OF ORGANIZATION | 0 |
| DR BARBARA YAWN | |||
| FAMILY MEMBER OF DR. ROY YAWN, PAST PRESIDENT | $204,947 | EMPLOYEE OF ORGANIZATION | 0 |
| MERCHANTS BANK | |||
| JOHN DOYLE, FORMER BOARD CHAIR, SERVES AS PRESIDENT OF MERCHANTS BANK | $523,941 | OPERATING LEASE PAYMENTS ON RIS/PACS SYSTEM AND THE EHR LEASE | 0 |
| EXPRESS SERVICES INCTAZ INC | |||
| NORM DOTY, FORMER TRUSTEE | $16,902 | TEMP STAFFING SERVICES | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF GOVERNORS IS ELECTED BY PHYSICIAN VOTE. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY AN EXTERNAL ACCOUNTANT. A DRAFT OF THE FORM 990 IS REVIEWED IN DETAIL BY THE FINANCIAL SERVICES MANAGER, CONTROLLER AND CFO. ANY NECESSARY CORRECTIONS AND ADJUSTMENTS ARE MADE. THE FORM 990 IS REVIEWED BY THE CEO AND CFO AND PRESENTED TO THE COMPENSATION COMMITTEE. THE FINAL FORM 990 IS MADE AVAILABLE TO THE BOARD MEMBERS FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | PER OMC POLICY THE BOARD OF TRUSTEES AND PRINCIPAL OFFICERS ANNUALLY SIGN CONFLICT OF INTEREST STATEMENTS. SIGNED CONFLICT OF INTEREST STATEMENTS ARE OBTAINED AND REVIEWED BY SENIOR MANAGEMENT ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15 | IN ORDER TO ENSURE THAT ALL OLMSTED MEDICAL CENTER (OMC) EXECUTIVE COMPENSATION DECISIONS ARE COMPETITIVE, EQUITABLE, UNIFORMLY ADMINISTERED, AND CONSISTENT WITH MARKET PRACTICES, OMC FOLLOWS RECOMMENDED BEST PRACTICES. THE GOALS OF EXECUTIVE COMPENSATION ARE TO ATTRACT AND RETAIN HIGHLY QUALIFIED PERSONNEL, TO MAINTAIN COMPENSATION LEVELS COMMENSURATE WITH THE SCOPE OF RESPONSIBILITIES FOR EACH POSITION, AND TO REWARD OUTSTANDING PERFORMANCE. OMC WILL SEEK MANAGEMENT TALENT BY CONDUCTING NATIONAL SEARCHES FOR QUALIFIED APPLICANTS FOR ANY VACANCIES AT THE CMO AND CEO POSITIONS IN ADDITION TO VICE PRESIDENT POSITIONS AS NECESSARY. THE SAME PHILOSOPHY IS APPLICABLE TO THE POSITION OF OMC PRESIDENT. PEER GROUPS FOR EXECUTIVE COMPENSATION, WHICH INCLUDES BASE SALARIES, INCENTIVE AND BENEFITS, WILL BE INTEGRATED HEALTH DELIVERY SYSTEMS WITH A MINIMUM OF A HOSPITAL AND AN EMPLOYED PHYSICIAN NETWORK AND NET REVENUES ROUGHLY SIMILAR TO THE REVENUES OF OLMSTED MEDICAL CENTER. OMC ENGAGES AN EXTERNAL CONSULTANT WHO COMPILES A PEER GROUP COMPENSATION AND BENEFIT ANALYSIS ON A TWO YEAR BASIS. MOST RECENTLY IN 2013, A COMPENSATION PEER REVIEW STUDY WAS COMPLETED FOR THE CEO, PRESIDENT,CMO AND ALL VICE PRESIDENTS AND PRESENTED TO THE BOARD OF GOVERNORS. THE EXECUTIVE COMPENSATION COMMITTEE OF THE OLMSTED MEDICAL CENTER CONSISTS OF FIVE ELECTED MEMBER OF THE BOARD OF GOVERNORS. THE EXECUTIVE COMPENSATION COMMITTEE WILL SET THE COMPENSATION OF THE PRESIDENT, CEO AND CMO AND MINUTES ARE KEPT OF THESE DISCUSSIONS. THE BOARD OF TRUSTEES, ACTING THROUGH THE BOARD OF TRUSTEES COMPENSATION COMMITTEE, MUST APPROVE THE EXECUTIVE COMPENSATION POLICY AND PROCESS OF DETERMINING EXECUTIVE COMPENSATION AND BENEFITS. IN ADDITION, THE PHYSICIAN SALARIES ARE CALCULATED ANNUALLY, USING REGIONAL PHYSICIAN SALARY COMPARISON GUIDES FACTORING IN PRODUCTIVITY AND QUALITY MEASURES, AND REVIEWED ON AN ANNUAL BASIS FOR MARKET REASONABLENESS BY MCGLADREY. THE PHYSICIANS RECEIVE NO COMPENSATION AS ATTENDING BOARD MEMBERS. THESE DISCUSSIONS ARE NOTED IN THE MINUTES OF THE BOARD OF TRUSTEES COMPENSATION COMMITTEE ANNUAL MEETING. THE BOARD OF TRUSTEES COMPENSATION COMMITTEE REPORTS TO THE FULL BOARD OF TRUSTEES ON AN ANNUAL BASIS THE COMPLETION OF SUCH DUTIES AND ARE ALSO NOTED IN THE MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. THE ANNUAL FORM 990 & ATTACHED AUDITED FINANCIAL STATEMENT REPORT IS AVAILABLE IN ACCORDANCE WITH THE PUBLIC INSPECTION OF THE RETURN REQUIREMENTS. |
| FORM 990, PART VII, SECTION A | BOARD MEMBERS ARE NOT COMPENSATED FOR THEIR SERVICES TO THE ORGANIZATION. COMPENSATION SHOWN FOR PHYSICIAN TRUSTEES IS RELATED TO THEIR POSITION AS AN EMPLOYED PHYSICIAN OF THE ORGANIZATION. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OMC RETAIL SERVICES LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 NINTH STREET SE | AddressLine1 |
| City | ROCHESTER | City |
| State | MN | State |
| ZIP Code | 55904 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460960716 | EIN |
| Primary Activities | PHARMACY | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Total Income | $505,905 | TotalIncomeAmt |
| End Of Year Assets | $707,363 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLMSTED MEDICAL CENTER | BusinessNameLine1 |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| OLMSTED MEDICAL CENTER REGIONAL FOUNDATION | ||||||||||
| 210 9TH STREET SE | ROCHESTER | MN | 55904 | 260022777 | HEALTHCARE EDUCATION AND COMMUNITY PURPOSES | MN | 501(C)(3) | LINE 11A, I | OLMSTED MEDICAL CENTER | Yes (1) |
| OLMSTED MEDICAL CENTER AUXILIARY | ||||||||||
| 1650 4TH STREET SE | ROCHESTER | MN | 55904 | 363382873 | SUPPORT OLMSTED MEDICAL CENTER | MN | 501(C)(3) | LINE 11C, III-FI | OLMSTED MEDICAL CENTER | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| OLMSTED MEDICAL CENTER REGIONAL FOUNDATION | ||
| B | $806,006 | GAAP |
| OLMSTED MEDICAL CENTER REGIONAL FOUNDATION | ||
| C | $39,413 | GAAP |
| OLMSTED MEDICAL CENTER AUXILIARY | ||
| C | $6,373 | GAAP |
| OLMSTED MEDICAL CENTER REGIONAL FOUNDATION | ||
| O | $340,228 | GAAP |
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